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NCT Number: NCT07726108

Digital Anticipatory Protocols at Triage to Improve ED Flow.

This study aims to evaluate a pre-post intervention adding an early management decision at the end of the triage process to improve patient throughput. The intervention consists of adding digital checkboxes to the electronic triage system, providing nurses with formalized options for anticipated management based on patient acuity. The study compares a pre-intervention phase (May 1st to July 31st, 2026) with a post-intervention phase (May 1st to July 31st, 2027) to naturalize seasonal confounders. The primary outcome is the total Emergency Department Length of Stay (ED LOS).

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Key information

Conditions

Length of Stay Diagnostic Tests Emergency Department Crowding Emergency Department Patient Emergency Department Triage Nurses Workflow

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Fribourg Cantonal Hospital

Villars-sur-Glâne, Canton of Fribourg, 1752, Switzerland

Location status: Recruiting

Location contact

Thomas Castelain

CONTACT

[email protected]

+41263061392

Youcef Guechi

CONTACT

[email protected]

Youcef Guechi, MD

PRINCIPAL_INVESTIGATOR

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • All patients over 18 years who registered at the admission desk during the study period.

Exclusion criteria

  • Arrival by emergency medical services (ambulance or helicopter)
  • Patient trajectory bypassing the standard nurse-led triage process
  • Patient directly referred to another service of the hospital after triage (gynecology, ophthalmology, etc.).

Treatment and study plan

Digital Anticipatory Protocols at Triage

Procedure

The intervention consists of adding digital checkboxes to the electronic triage system. This provides nurses with formalized options for anticipated management based on patient acuity, aiming to encourage and document anticipatory actions while stimulating clinical reasoning.

Primary outcomes

  1. Total Emergency Department Length of Stay (ED LOS).

    Time frame: Through completion of the ED visit, up to a maximum of 72 hours.

    The time interval from the completion of the patient's administrative registration to their physical departure from the ED

Secondary outcomes

  1. Left without being seen (LWBS)

    Time frame: Through completion of the ED visit, up to a maximum of 72 hours.

    Proportion of patients who registered at the ED admission desk and left before receiving a medical screening exam or an evaluation by a physician

  2. 30-day mortality

    Time frame: Up to 30 days post-ED visit

    Assessed through institutional medical records to evaluate safety

  3. Intesive Care Unit (ICU) transfers

    Time frame: Up to 7 days post-ED visit

    Proportion of patients transferred to the Intensive Care Unit (ICU) immediately and within 7 days after the ED visit

Other outcomes

  1. Time From Triage Assessment to Disposition Decision

    Time frame: Through completion of the ED visit, up to a maximum of 72 hours.

    The time interval, measured in minutes, elapsed from the beginning of the nursing triage assessment to the exact moment a definitive disposition decision (e.g., discharge, admission) is entered by the emergency physician.

    A disposition decision is operationally defined as the precise moment the attending emergency physician determines that active emergency care is complete. This includes the decision to transfer the patient to a hospital ward (for admissions) or the conclusion of clinical management (for discharges), even if the patient remains in the emergency department awaiting purely logistical arrangements, such as medical transport or family arrival. The measurement tool used to assess and timestamp this outcome is a standardized digital disposition decision tag integrated into the electronic health record.

  2. Time From Treatment Room Placement to Disposition Decision

    Time frame: Through completion of the ED visit, up to a maximum of 72 hours.

    The time interval, measured in minutes, elapsed from when the patient is placed in an ED treatment room to the exact moment a definitive disposition decision (e.g., discharge, admission) is entered by the emergency physician.

    A disposition decision is operationally defined as the precise moment the attending emergency physician determines that active emergency care is complete. This includes the decision to transfer the patient to a hospital ward (for admissions) or the conclusion of clinical management (for discharges), even if the patient remains in the emergency department awaiting purely logistical arrangements, such as medical transport or family arrival. The measurement tool used to assess and timestamp this outcome is a standardized digital disposition decision tag integrated into the electronic health record.

Study contacts

Contact information is provided by the study sponsor or research team.

Thomas Castelain

CONTACT

[email protected]

+41263061392

Youcef Guechi

CONTACT

[email protected]

+41263063142

Sponsors and collaborators

Lead sponsor

Hôpital Fribourgeois

Other

Collaborators

  • University of Fribourg

Registry information

Official study title

Implementing Digital Anticipatory Protocols at Triage to Improve Emergency Department Flow: A Before-After Study Protocol

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Jul 24, 2026
Registry last updated
Jul 24, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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